Rethorn Zachary, Barlow Susan J, Gavlick Emily
a Department of Physical Therapy , University of Tennessee at Chattanooga , Chattanooga , TN , USA.
b Siskin Hospital for Rehabilitation , Chattanooga , TN , USA.
Physiother Theory Pract. 2017 Mar;33(3):254-259. doi: 10.1080/09593985.2017.1288281. Epub 2017 Feb 22.
Case report.
Dizziness is a common and debilitating condition across the lifespan. Patients with this complaint must be carefully examined to determine the cause of dizziness, rule out the presence of central nervous system dysfunction, and determine the appropriateness of physical therapy intervention.
A 90-year-old male was referred to physical therapy six months after the onset of dizziness. A thorough history was taken and examination was performed. Signs consistent with central nervous system dysfunction and peripheral vestibular dysfunction were observed. The patient was treated for the peripheral vestibular disorder and referred back to his physician for further testing. Imaging revealed that the patient had idiopathic normal pressure hydrocephalus.
This case illustrates the need for physical therapists to perform thorough examinations of patients with a primary complaint of dizziness and properly interpret positive central signs, indicating a potential need for referral to a physician or other healthcare provider when they appear.
病例报告。
头晕是一种在整个生命周期中常见且使人衰弱的病症。对于有此主诉的患者，必须进行仔细检查，以确定头晕的原因，排除中枢神经系统功能障碍的存在，并确定物理治疗干预的适用性。
一名90岁男性在头晕发作6个月后被转诊至物理治疗科。进行了全面的病史采集和检查。观察到与中枢神经系统功能障碍和外周前庭功能障碍一致的体征。该患者接受了外周前庭疾病的治疗，并被转回其医生处进行进一步检查。影像学检查显示该患者患有特发性正常压力脑积水。
本病例说明物理治疗师有必要对以头晕为主诉的患者进行全面检查，并正确解读阳性中枢体征，当这些体征出现时，表明可能需要转诊给医生或其他医疗服务提供者。
